Loading...
HomeMy WebLinkAbout1602DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 34. -5 -72 BOX 15 ,lff i III rF m : 11 T &�6 �. . ,lff i U PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES WELL COMPLETION REPORT W -12 -00 NOTE: Exact location of well with distances to at least two permanent landmarks to be provided on a separate sheeVplan. r .. 1 Well Driller's Name MI U I L L I N G4 INC. Address:75 Putnam Ave., Brewster NY Signature: tA MITIM A Date: 6/9/00 White copy: HD File; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy- Well driller Form WC -97 415 Farm to Market Rd. Towtf/Village. " "` " PATTERSON Tia— Grid - #" Map 34 Block 5 Lpt(s) 72 Well Owner: Name: Address: WAYNE & ANNE PEARSON, 415 Farm to Market R'd,, Brewster Use of Well: 1- primary 2- secondary x x Residential Business Industrial Public Supply Air cond/heat pump Irrigation Farm Test/monitoring Other(specify) Institutional Standby Drilling Equipment Rotary Cable percussion x x Compressed air percussion Other (specify) Well Type Screened Open end casing x_ Open hole in bedrock Other Casing Details Total length 5-1 ft. Length below grade 4 9__ft. Diameter 6 in. Weight per foot 17 lb /ft. Materials: x x Steel Plastic _ Other Joints: _ Welded � Threaded _ Other Seal: _ Cement grout x x Bentonite Other Drive shoe: x x Yes- - No Liner: Yes No Screen Details Diameter (in) Slot Size Length(ft) Depth to Screen (ft) Developed? First Yes No Hours Second Well Yield Test Bailed Pumped xx Compressed Air Hours 6 Yield —2-0- gpm Depth Data Measure from land surface- static (specify ft) 50 During yield test(ft) 300 Depth of completed well in feet 365 Well Log If more detailed information descriptions or sieve analyses are available, please attach. Depth From Surface Water Bearing Well Diameter(in) Formation Description ft. ft. ; Land surface 3 1 0- 3 4 T O s o i l 3 15 10 -3/4 Soft weathered ledge _ _ 5._ _..._. 4 G . _... 1 �O -3,j 4. . Ke d i u m . to, hard . r. a nA t e. 40 2.00 6 6 -1/8 Hard granite 20 300 8 6-1/8 White quartz 30 360 20 6 -1/8 Grey. granite If yield was tested at different depths during drilling, list: Feet Gallons Per Minute Pump /Storage Tank Information 200 6 Pump Typ %ubmersi b(Tepacity 13 Depth .300 Model 11W041 2 Voltage 230 HP 2 Tank Type Di ragmVolume 86 gallon 300 8 365 2 0 Date Well Completed 6/7/00 Putnam County Certification No. 2 Date of Report 6/9/00 Well D (s nature) NOTE: Exact location of well with distances to at least two permanent landmarks to be provided on a separate sheeVplan. r .. 1 Well Driller's Name MI U I L L I N G4 INC. Address:75 Putnam Ave., Brewster NY Signature: tA MITIM A Date: 6/9/00 White copy: HD File; Yellow copy -Building Inspector; Pink copy - Owner; Orange copy- Well driller Form WC -97 rim �._...,.._.�,_ . ti.. ,. ..... .. ;... ,.... i Ira»., ..... �N <, o. ... �. _ . . _.. __..- _ _ .. .. .. � .._ ..._ . _ ..._..,.._...� -� ,..-._ er ,... _. e, _.. __ _.. ,.. _._..... .__.. _. .. _ _ .. ._ _ .. .. ._. ... �._. ... .. .. ...��� NORTHEAST LABORATORY OF DANBURY 39' M1LL --PLAEN -RoAi3 = DANBURY, - CT - 06811 r: _ - = CT:Cert: PH -0404• - (203) 748 -7903 - FAX (203) 748 -0652 NY Cert: 11471 LABORATORY REPORT -- WATER SUPPLY TESTING REPORT TO: MILL DRILLING, INC. 75 PUTNAM AVENUE BREWSTER, N.Y. 10509 SAMPLE SITE: SAMPLING POINT: SOURCE: TREATMENT: TEST PERFORMED BACTERIAL:6 /27/2000 Total Coliform (Bacteria) PHYSICALS: 6/27/2000 - Color Odor pH 6/27/2000 - Turbidity CHEMISTRY: Nitrite N Nitrate N ._ ... Alkalinity _....... - .. _..... Hardness 6/27/2000 - Iron Manganese ml = milliliter * *Notification Level Sodium Lead DATE SAMPLE COLLECTED: 6/7/2000 6/27/2000 T ME COLLECTED: 9:22 A.M. & 2:15 P.M. COLLECTED BY: ROB MILL DATE RECEIVED @ LAB: 6/7/2000 & 6/27/2000 TESTED BY: LAB# 11471 REPORT DATE: 6/28/2000 PEARSON, FARM TO MARKET, PATTERSON, N.Y. WELL HEAD WELL -NEW NONE RESULT: 0 per 100 ml 5 ND 7.46 0.70 NTUs <0.005 mg/L as N 0.93 mg/L as N .64.0.. mg/L -102.0 ..... mg/L - 0.075 mg/L 0.060 mg/L 4.3 mg/L 0.003 mg/L MAXIMUM CONTAMINANT LEVEL 0 per 100 ml 15 3 Units no designated limit 5 NTUs 1 mg/L as N 10 mg/L as N no designated limits _ . ••no designated�limits - _ ... ........ 0.30 mg/L 0.30 mg/L [Note: Combined Limit for Iron plus Manganese = 0.50 mg/L] 20 mg/L ** 0.015 * ** mg/L = milligrams per Liter r]D = none detected NTU=Urits * "Action Level RESULTS BASED ON SAMPLES SUBMITTED: 6n/2000 & 6/27/2000 SAMPLE, AS TESTED ABOVE: X or CkOT POTABLE (PER NEW YORK STATE DEPT. OF HEALTH SERVICES STANDARDS FOR POTABLE WATER) �. 'ire y Laboratory Director *NORTHEAST LABORATORY, 129 MILL STREET, BERLIN, CT 060370 (860)828 -9787 - FAX (860)829 -1050 TOLL FREE WITHIN CT: 800 - 826 -0105 e OUTSIDE CT: 800 - 654 -1230 IPUTNAM COUNTY Y DIEIPARTIViI]ENT OF HEALTH DI VRSffG Y OF IENVRROIMENTCAL HEALTH SIERVffCIES ...AAPIPL)IC LL. -..,_ ATI< ®IY ®I�1STII8U T A WATiE please print or type PCHD Permit # Weld Location: Street Address: Town/Village Tax Grid #372400- 34 -5 -72 415 Farm to Market Road Patterson, NY Map Block Lot(s) WeRR Owneir: Name: Address: Wayne Pearson 415 Farm to Market Rd., Brewster, NY Use of WeDh xx Residential Public Supply Air /Cond/Heat Pump Irrigation I -PR immauy Business Farm Test/Monitoring Other (specify) 2- secondairy Industrial Institutional Standby Amount of Use Yield Sought 5 gpm # People Served 4 Est. of Daily Usage _dal. Reason ffoir xx Replace Existing Supply Test/Observation Additional Supply DARKag New Supply (new dwelling) Deepen Existing Well Detailed Reason Low.PH. Very corrosive water. Low yield. Not cost efficient for treatment. for HDrffing WeR Type xx Drilled Driven Gravel Other Is well site subject to flooding? ................................................. ............................... Yes No xx Is well located in a realty subdivision. Yes No xx Name of subdivision n/a Lot No. Water Well Contractor: tjiLL DRILLINGS INC. Address:75 Putnam .Ave, , Brewster, NY Is Public Water Supply available to site? .................................. ............................... Yes No xx Name of Public Water Supply: n / a TownfVillage Distance to property from nearest water main: 'nla Proposed well location & sources of contamination to, e pr vid on sepay4ke sheet/plan. Date: - .4./.1..2/00. ... Applicant Signature: _ AIIY,91,�2 _ IPEP397 TO CONSTRUCT A\ WATER WELL This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided that within thirty (30) days of the completion of water well construction, the applicant or their designated representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or well driller shall take appropriate action to assure that any and all water and waste products from such well drilling operations be contained on this property and in such a manner as not to degrade or otherwise contaminate surface or groundwater. APPROVED. FOR CONSTRUCTION.- This approval expires two years from the date issued unless construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be amended or modified when considered necessary by the Public Health Director. Any revision or alteration of the approved plan requires a new permit. Well to be constructed by a water te driller certified by Putnam County. �, J PU Date of Issue 6 Z 6V Permit Date of Expiration O Title: _ IPeirmmit is Non- Trransffeir a>fDIl White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; �Av W a c1 Orange copy - Well MI. r Form WP -97 Street Town State Zip PERSON IN CHARGE` /4. TNI Name and e 6t3 TYPE OF.FACILITY; n FINDINGS: AA' P Dear APPENDIX IE 0% "IMMIUM-111i a i Date RE: Department of Health Review of Proposed Sewage Treatment System for Property Name: Address: t-Ae 6K Town: Tax Map 7Z Please be advised that an application for a Construction Permit relative to the construction of a sewage system and/or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. '' If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call the Health Department at (914) 278 -6130. Received By. Address: Tax Map #: toC)L � August, 1999 � �'5 � AppndxE Verb LIZA 1 � S 4V 25 APPENDIX E Date RE- Department of Health Review of Proposed Sewage Treatment System for Property Name: Address: l' ,arum Town. Tax Map #: — 5 — 7Z Dear a, Please be advised that an application for a Construction Permit relative to the construction of a sewage system and/or well proposed for the captioned property has been made to the Putnam County Department of Health. Attached please find a copy of the latest site plan. If you have any questions, concerns or information which may bear on the Health Department's review of this application, you may call the Health Department at (914) 278 -6130. L Received By: Address: Tax Map #: 3 -� -- )0 August, 1999 AppndxE Very truly /y rs, B: Y Title: ULLO 11".INC. 7E KM4W AVENUE NY �papg.111t ati� :i�� � Si,�ks • -41g t 't -� t N t 1 470. 22 . '4 .�� r �QP�jk1 r WI. �w 76 am ,``rte A C. 25� k 09.9 2, �N 4 lb Im , t j'•c .• AC. s y6 2 , "\p 0 A , Ap.e t �° J aar,u F:lSev ®L� ��< �� _...: 963.4:. __...�... _._.._._..._... _ ............ ......._ .�.. fr. r 12 AC. pakM4�y, � 3 7 67 s� > *gins # 0 CAL. M jr(/' N ru /yam 4. AC. CAL. � 7 t y r �° ` 253, 93 1 ®4.34 69.6 X65 ]��[ OWNER: WAYNE PEARSON 415 Farm to Market Rd. Brewster NY 10509 ko lei] ARTESIAN WELL CONTRACTORS Putnam Ave. Brewster, N.Y. 10509 19'141 279 -5041 1 ODD rA r f L T iw ri. r, �V f� .r ;t .;c try 'a i t i ( ) 1 PUT NAM COUNTY DEPARTMENT OF HEALTH H C! Division of Environmental Health Services, Carmel, N. Y. 10512 t CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM P- 61_1` -Scxc) CT 1 Town or Village Located at FA-e4y` —fJ Section `71 ' 1 �O +' ( Block Owner W b �i C'. �G —�� �'� Lot �d� /� `�' �" Job Separate Sewerage System built by ICCJdI°_ f i Y 1C� �1 e�� Address � u Consisting of i0d<D Gal. Septic Tank �S lineal Feet X -2 width trench it Other requirements Water Supply: Public Supply From Private Supply .Qwiiied- By y� e `�AQAi✓ 'SEE: Address " Building Type TA""' ` �ni-� -5 • No. of Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises were constructs? attached), and in accordance with the standards, rules and regulations; plans Date --• 7— o Certified by Address , I u M A. X0,5,, Date Permit Issued of the completed work (copies of which are he Putnam County Department of Health. P.E. R.A. "+� License No. —1 Z>-6 Any person occupying premises served by the above system(s) shall promptly to a su ! necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become 1 and void as soon as a public sanitary sewer becomes ,available and the approval of the private water supply shall become null abd void when 'a public water supply becomes available. Such approvals are •«subject to modification or change when, in the judgment of the Commissioner of Health, suct cation, modification or change is necessary. Date BY Title , i r .;k i t i ( ) 1 PUT NAM COUNTY DEPARTMENT OF HEALTH H C! Division of Environmental Health Services, Carmel, N. Y. 10512 t CERTIFICATE OF CONSTRUCTION COMPLIANCE FOR SEWAGE DISPOSAL SYSTEM P- 61_1` -Scxc) CT 1 Town or Village Located at FA-e4y` —fJ Section `71 ' 1 �O +' ( Block Owner W b �i C'. �G —�� �'� Lot �d� /� `�' �" Job Separate Sewerage System built by ICCJdI°_ f i Y 1C� �1 e�� Address � u Consisting of i0d<D Gal. Septic Tank �S lineal Feet X -2 width trench it Other requirements Water Supply: Public Supply From Private Supply .Qwiiied- By y� e `�AQAi✓ 'SEE: Address " Building Type TA""' ` �ni-� -5 • No. of Has Erosion Control Been Completed? I certify that the system(s) as listed serving the above premises were constructs? attached), and in accordance with the standards, rules and regulations; plans Date --• 7— o Certified by Address , I u M A. X0,5,, Date Permit Issued of the completed work (copies of which are he Putnam County Department of Health. P.E. R.A. "+� License No. —1 Z>-6 Any person occupying premises served by the above system(s) shall promptly to a su ! necessary to secure the correction of any unsanitary conditions resulting from such usage. Approval of the separate sewerage system shall become 1 and void as soon as a public sanitary sewer becomes ,available and the approval of the private water supply shall become null abd void when 'a public water supply becomes available. Such approvals are •«subject to modification or change when, in the judgment of the Commissioner of Health, suct cation, modification or change is necessary. Date BY Title , i r s e Municipality Section Block Lot GUARANTY OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the.standards, rules and regulations of the Putnam County Department of Health, and hereby guaranty to the owner, his succes- sors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of initial use of the sewage disposal system, or any repairs :Wade by me to such system, except where the failure to operate properly is caused by the willful or negligent act'of the occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive the de- termination of the Director of the Division of Environmental Health Ser- vices of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this /U day of /'U 198"/, Signa ure! Title R MAYES CONS CO., INC.. If corpcBRffM ROAftve name and PI4, N, Y, 12570 THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health RECEIVED' MAR 2 91992 PUTNAM COUNTY DEPT. OF HER''' Owner or . _ urc Purchaser . o Building . P-:-.9 .r Building �i""ding Constructed - by Location - Street a ov4 Ld.. Municipality Section Block Lot GUARANTY OF SEPARATE SEWAGE SYSTEM I represent that I am wholly and completely responsible for the location, workmanship, material, construction and drainage of the sewage disposal system serving the above described property, and that it has been constructed as shown on the approved plan or approved amendment thereto, and in accordance with the.standards, rules and regulations of the Putnam County Department of Health, and hereby guaranty to the owner, his succes- sors, heirs or assigns, to place in good operating condition any part of said system constructed by me which fails to operate for a period of two years immediately following the date of initial use of the sewage disposal system, or any repairs :Wade by me to such system, except where the failure to operate properly is caused by the willful or negligent act'of the occu- pant of the building utilizing the system. The undersigned further agrees to accept as conclusive the de- termination of the Director of the Division of Environmental Health Ser- vices of the Putnam County Department of Health as to whether or not the failure of the system to operate was caused by the willful or negligent act of the occupant of the building utilizing the system. Dated this /U day of /'U 198"/, Signa ure! Title R MAYES CONS CO., INC.. If corpcBRffM ROAftve name and PI4, N, Y, 12570 THREE (3) COPIES ARE REQUIRED WITH THREE (3) COPIES OF FINAL PLANS BEFORE CERTIFICATE OF COMPLETION WILL BE ISSUED. GUARANTOR IS REQUIRED TO FILE NOTICE OF DATE OF FIRST USE OF SYSTEM. Division of Environmental Health Services, Putnam County Department of Health RECEIVED' MAR 2 91992 PUTNAM COUNTY DEPT. OF HER''' WATER dst7AIYffiU0 BACTERIOLOGICAL. EXAMNA71ON Colifor'm* Couat, NF Method : ® dear 100 nd. This veladlt iwdicetel the iearce of the wiplo was of 'ratlllcgORjt laoddrq- Q&f4liejf wh.W , ok-0 f"Ar Wei collected. P April 18o 1.981 E VV ® MAR 2 91982 PUtKAr; 2c aEJ v 0�0 f. 6 F HEAL B e WELL COMPLETION REPORT 3/71 PUTNAM COUNTY DEPARTMENT OF HEALTH Division of Environmental Health Services COUNTY OFFICE BUILDING - CARMEL, NEW YORK This report is to be completed. by well driller and submitted to County Health Department together with laboratory report of - ro analysis,afmater- saTnple indicating water is-of satisfactory bacterial quality before certificate'of -construction compliance is" issued. REPORT MUST BE SUBMITTED WITHIN 30 DAYS OF WELL COMPLETION OWNER NAME Wayne Pearson ADDRESS Farm to Market Rd., Patterson, NY 12563 LOCATION OF WELL (No. & Street) (Town) (Lot Number) SAME PROPOSED USE OF WELL BUSINESS DOMESTIC ❑ E TABLISHMENT FARM ❑ TEST WELL 11 SUPP Y El INDUSTRIAL ❑ CONDITIONING ❑ ((SSpe ify) DRILLING EQUIPMENT X COMPRESSED CABLE OTHER ROTARY ❑ AIR PERCUSSION ❑ PERCUSSION ❑ (Specify) CASING DETAILS LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT ❑ THREADED ❑ WELDED rIE SHOE YES ❑ NO CrA3Rf7G YES NO YIELD TEST 65 8 11 BAILED E] PUMPED ❑ COMPRESSED AIR HOUR G.P.M. 2 YIELD (G .J 81 WATER LEVEL MEASURE FROM LAND SURFACE —STATIC (Specify feet) DURING YIELD TEST [feet) Depth of Completed Well ' in feet below Land surface: 1019 SCREEN DETAILS MAKE LENGTH OPEN TO AQUIFER (feet) SLOT SIZE DIAMETER (Inches) IF GRAVEL PACKED: Diameter of well including gravel pack (Inches): GRAVEL SIZE (Inches) FROM (leet) I TO (lest) DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, to at least two permanent landmarks. FEET to FEET R MAR 2 9 79E2 PUrNA M COU DEPT, PV - Y OF If yield was tested at different depths during drilling, list below FEET GALLONS PER MINUTE DATE WELL COMPLETED DATE OF REPORT March 1 5, WELL DRILLER a e) 982 Address Other Requirements :1 represent that "ll am wholly completely 4o y abo . ve-describled will rutted -as:shown-on the approv placC !on, tance 61 t f. ti Date 1F_ APPROVEDFOR CONSTAUi APPROVE_ or may be Date cn ie de, amei eoVe I will': approved pl i and -that ,said �­ fi w begins we Signed*'_ N.:. - I on hi em(s),; -1) that the separate - sewage , disposal system' in& standards rules and regulations o e Putnam tisfactory,to the di)mmissl6ner of Healthwill it: r: assign s 'PY ihe:bj4 Ilder; -that, said builder .,W I two s imniediately4ollow.ing the date -of the isiu, a th to 2).,that the drilled well described above sta air 'rltilesrand regu7IkTl`3R79f the Putnam P, F: Llcense No. V6 of the 66ildirill,-has been undertaken and is ith-.' Any tha I n'g . e or . alteration i - on of construction . . _;MI::I65 T' E bF HEALA�, UN V. -�A fidsh� 4 Envrronmenial -Health Services, i, 5� . .. ... . CONSTR CT -PERMiT F0 _9EW*iG4�:PIISP0SAL SYSTEM -; P, F_t 42 e�'S a. ,Town oFQI Locatetl Tax- "Map �@lock, Subdivision Job, Addre ss Qwndir Building Type Number of Bedrooms — ''Design •Flow are Feet L t : .al. Septic T4pk-. apd.,"-.i� Separate Sewerage Syst6m, o pa' 0 c, be constructed by To on V --Z �ater..Su ubliF.I�:Mp­pi7y, pply�:­ p ',Fiorn - - i;s P 64, Private- ;Supply rivi Address Other Requirements :1 represent that "ll am wholly completely 4o y abo . ve-describled will rutted -as:shown-on the approv placC !on, tance 61 t f. ti Date 1F_ APPROVEDFOR CONSTAUi APPROVE_ or may be Date cn ie de, amei eoVe I will': approved pl i and -that ,said �­ fi w begins we Signed*'_ N.:. - I on hi em(s),; -1) that the separate - sewage , disposal system' in& standards rules and regulations o e Putnam tisfactory,to the di)mmissl6ner of Healthwill it: r: assign s 'PY ihe:bj4 Ilder; -that, said builder .,W I two s imniediately4ollow.ing the date -of the isiu, a th to 2).,that the drilled well described above sta air 'rltilesrand regu7IkTl`3R79f the Putnam P, F: Llcense No. V6 of the 66ildirill,-has been undertaken and is ith-.' Any tha I n'g . e or . alteration i - on of construction . . *i PUTNAM COUNTY DEPARTMENT OF HEALTH DIVISION OF ENVIRONMENTAL HEALTH SERVICES COUN'T'Y OFFICE BUILDING, CARMEL, N. Y. 10512 DESIGN DATA SHEET- SEPARATE SEWAGE DISPOSAL SYSTEM FILE NO. J Owner WA(,j j)e C. Pj__e_C N) � Address ��►� ! c7:JST�� �vl Located at ( Street fA"l � �tAV --T' CD -See. Block Lot ?AA . �TH- ica e nearest cross s ree Municipality Watershed SOIL PERCOLATION TEST DATA REQUIRED TO BE SUBMITTED WITH APPLICATIONS Hole Number CLOCK TIME PERCOLATION PERCOLATION Elapse Depth to Water Water Level No. Time From Ground Surface in Inches Soil Rate Start -Stop Min. Start Stop Drop in Min. /in drop Inches Inches Inches 1 To 1 a 2-1 -2-t o 1 7- � 5 � 2 q " Z(4, ZI 3 U 3 �g 10'Z 2 - 4 5 ? 11a�q�� 4 -_. 401_ � ®`..C� . ..._ _ �. .. . � .. _ .._ - _..... -..l o ...._... 3 � �o4 3.0 ' a 1 i 2 t 3 9 4 01 NVI, dr ,,tt V N 5 ru,;._ Notes: 1) Tuts to be repeated at same depth until approximately equal soil rates are obtained at each percolation test hole. All data to be submitted for review. 2) Depth measurements to be made from top of hole. TEST PIT DATA REQUIRED TO BE SUBMITTED WITH APPLICATION DESCRIPTION OF SOILS ENCOUNTERED IN TEST HOLES DEPTH HOLE NO. 8 HOLE NO. HOLE NO. ®. 6" �✓ ;:1� CIE? 12" 18" S�r.vg, y Vic. 24" 3011 421t Si L, -' 48" J/ 5411 60" 66" 72•' 78'► 84" 4 SP. AM, S b� F- INDICATE LEVEL AT WHICH GROUND WATER IS ENCOUNTERED---- INDICATE LEVEL TO WHICH WATER LEVEL RISES AFTER BEING ENCOUNTERED TESTS MADE BY }�:�a E°sz . Date 1?--5I - DESIGN 'Soil "Drop: S.D. Usable Are cc�o No. of Bedrooms 3 Septic Tank Capacit A. Absorption Area Provided By.li,," .F.x24" �� ggt-- r c name 'V J( LL i A of A . L (Z�A bignature Address 'PO. &.)K - S L � cep 421 8 p��FfSSIosxP THIS SPACE FOR USE BY HEALTH DEPARTMENT ONLY: Soil Rate Approved Sq. Ft /Gal. Checked by Date t Wayne & Anne Pearson Farm to Market Road Brewster, NY 10509 Dear Mr. & Mrs. Pearson: JOHN KARELL Jr., P.E., M.S. „Public Health Director DEPARTMENT OF HEALTH Division Of Environmental Health Services 4 Geneva Road, Brewster, New York 10509 (914) 278 -6130 March 8, 1993 Re: Proposed addition - Pearson, Farm to Market Rd. (T) Patterson TM #34 -5 -72 I have received and reviewed the plans for the proposed addition to the above mentioned residence. The plans indicate that a 25' 6" x 16' addition will be added consisting of a family room, enlarged kitchen and bathroom. The survey indicates that sufficient area exists to expand or repair the sewage disposal system, should it become necessary in the future. Therefore, based on the information submitted, the above mentioned addition is APPROVED with the following conditions: 1. The total number of bedrooms must remain at 3 without prior approval by this Department. 2. The area of the existing sewage disposal system, and its expansion area, must be maintained. ' ' " 3. All plumbing fixtures must be replaced or updated with water saving devices, i.e., low flush toilets, restrictors for shower heads and faucets, etc. Approval is granted for sewage disposal only. Any other permits or variances required are the responsibility of the applicant and the jurisdiction of the Town of Patterson. If you have any questions, please contact me at your convenience. Very truly your William Hedges Sr. Public Hsalth Sanitarian WH /jp cc: BI (T) Patterson �.,_ I - $ V y N 1 c r f N< •C + r r.. feq 1 WYNI—xv WK Qg a _ �. 1 A r J .. '•f,' r k� ""F H. 1�t T +^ ! t ��F r 1 Y. Y 4', +.a,.^ �QQ 27i � ♦ aft r`'k +., ?� n ;�.. 5r' Ann, PI �'1Y ~�R <ytYt u4rnKerth t`F ?5.. ¢1 c%k}f, . .O3j. pq ,t G d4 YF^ r'3 f +�, t�V � lya � ti �� +j♦ - ;, rx q t t 1 ... 1'rIJ) t_ � F�'vl'�' x r� �t ��1 e� ,...� �r• r ... � . rr� lb Who TJ XV "i" -T, rt w A, to no, oil A 14 1A nil lo. a lbi f n� w KIM Mai 6 wo Mae, no" kill Qj R NO," VA. hit IS ASS 10 ARM WK vV ow % S A • ANT V SWAIM . i. J\ r• is A on, UPS . . . . . . . . . . . on p rk ,w )jr � t.p � Kk', 1 jQ rV Ono Q g° sop ON tti 01 A 7, r­ OWN WIT-1- Z_ Air fit r SO V"Z VU, T 'v- QQ Noon "'. MaSSM matzo a MAAS t f"W" 40— owl SIR V. 1 WS 'I A ME